The Chain Mediating Role of Hope and Posttraumatic Growth Between Social Support and Psychological Distress Among Lung Cancer Patients.

IF 2.6 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2025-07-16 eCollection Date: 2025-01-01 DOI:10.2147/CMAR.S522791

Jin-Gui Huang, Chen-Han Xu, Yu-Mei Shi, Juan Jiang, Feng-Mei Huang, Ling-Li Xu

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Abstract

Purpose: This research was designed to explore whether hope and posttraumatic growth (PTG) played a mediating role between social support and psychological distress in patients diagnosed with lung cancer.

Patients and methods: A hospital-based cross-sectional study was carried out on 502 lung cancer patients. From September 2023 to April 2024, participants were recruited via convenience sampling from one tertiary cancer hospital and two tertiary general hospitals in Chongqing, China. Patients completed questionnaires on demographics, medical information, Distress thermometer, Perceived Social Support Scale, Posttraumatic Growth Inventory, and Herth Hope Index. Statistical analyses included Pearson's chi-squared test or Fisher's exact test for differences in patient characteristics by psychological distress level. Pearson correlation analysis explored relationships among variables. Bootstrapping in structural equation modeling (SEM) evaluated structural paths, and multi-group SEM analysis tested the moderating effect of gender.

Results: 43.6% (219/502) of lung cancer patients experience psychological distress. After controlling for cancer stage and distant metastasis, the results suggested that social support had a negative direct effect on psychological distress. In addition, social support could also influence psychological distress via three pathways: (1) the mediating effect of hope, (2) the mediating effect of PTG, and (3) the serial mediating effect of hope and PTG. The indirect effect of the three intermediary paths accounted for 72.7% of the total effect. Gender moderated the effect of social support on PTG (β = -0.286, P = 0.001).

Conclusion: This study found that lung cancer patients exhibit high levels of psychological distress. Social support directly impacts psychological distress and acts through multiple pathways: the mediating effects of hope and PTG, as well as their serial mediation. These findings deepen our understanding of how social support affects psychological distress in lung cancer patients and its underlying mechanisms, providing empirical support for developing interventions to alleviate distress.

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希望与创伤后成长在社会支持与肺癌患者心理困扰之间的连锁中介作用

目的：探讨希望和创伤后成长（PTG）是否在社会支持与肺癌患者心理困扰之间起中介作用。患者和方法：对502例肺癌患者进行了以医院为基础的横断面研究。从2023年9月至2024年4月，通过方便抽样的方式从中国重庆的一家三级肿瘤医院和两家三级综合医院招募参与者。患者完成人口统计、医疗信息、痛苦体温计、感知社会支持量表、创伤后成长量表和赫斯希望指数调查问卷。统计分析包括皮尔逊卡方检验或Fisher精确检验，以确定患者心理困扰程度的特征差异。Pearson相关分析探讨变量之间的关系。结构方程模型（SEM）中的Bootstrapping评估了结构路径，多组SEM分析检验了性别的调节作用。结果：43.6%（219/502）的肺癌患者存在心理困扰。在控制癌症分期和远处转移后，社会支持对心理困扰有负向的直接影响。此外，社会支持对心理困扰的影响还可以通过三个途径实现，即：(1)希望的中介效应；(2)PTG的中介效应；(3)希望和PTG的串联中介效应。三种中介路径的间接效应占总效应的72.7%。性别调节社会支持对PTG的影响（β = -0.286, P = 0.001）。结论：本研究发现肺癌患者表现出高水平的心理困扰。社会支持直接影响心理困扰，并通过多重途径起作用：希望和PTG的中介作用，以及它们的连环中介作用。这些发现加深了我们对社会支持如何影响肺癌患者心理困扰及其潜在机制的理解，为制定缓解痛苦的干预措施提供了实证支持。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.